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CASE REPORT A 66-year-old female underwent a colonoscopy for evaluation of diarrhea. Two polyps were seen (10 mm and 20 mm) in the ascending colon. Due to poor preparation in the right colon, a polypectomy was not pursued. Because the lesions were hard to identify, 2 tattoos were placed 3 cm distal to each polyp. It was discovered that instead of Endomark (PMT Corporation, Chanhassen, MN), undiluted methylene blue was injected in the submucosa (Figure 1). Eight days later a repeat colonoscopy was performed to attempt polypectomy. Two deep, necrotic, exudate-covered ulcers were at the site of the tattoos, each measuring about 20 mm (Figure 2). No bleeding was present. The polyps were successfully removed with saline injection snare

Endoscopic Tattooing: From Blue to Black